Pre-op days

Notes on my Friday and Saturday, doing things, with the help of Elizabeth Traugott, to get ready for surgery on Wednesday. Friday afternoon at the Palo Alto Medical Foundation (family practice and physical therapy), Saturday morning at the Stanford University Medical Center and the Footwear Etc. store in Palo Alto. (Otherwise, a lot of exhausted sleep.) With some linguistic observations along the way.

Friday. First, a satisfying visit to the family doctor, for a pre-op physical (required by my orthopedic surgeon, largely to insure that the surgeon and anesthesiologist have all the relevant background information they might need). A rather long time, mostly filled with comments like “wonderful”, “perfect”, “keep it up”, etc. My heart is fabulous, in the EKG and a pleasure to listen to, apparently. Cholesterol counts perfect, A1C test (long-term blood sugar) excellent, my breathing clearer than either of us could remember (but I’m supposed to go back on asthma meds now that cold weather is upon us). Blood pressure beautiful (it was somewhat high last time, probably due to the stress of being freshly in the grip of great pain). Losing weight, even.

Digression on the A1C — a definitely opaque name, which turns out to be less interesting than you might have hoped. From the Wikipedia page on glycated hemoglobin:

Glycated hemoglobin [or glycohemoglobin] or glycosylated hemoglobin ([hemoglobin A1c – type A hemoglobin — with various orthographic variants, including hemoglobin A1C]) is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin’s exposure to plasma glucose. Normal levels of glucose produce a normal amount of glycated hemoglobin. As the average amount of plasma glucose increases, the fraction of glycated hemoglobin increases in a predictable way. This serves as a marker for average blood glucose levels over the previous [2 to 3] months prior to the measurement.

The A is just a type of hemoglobin, picked out by a letter of the alphabet; A is by far the most common type (constituting over 95%), but other types include C, F, H, and S. Then the 1 picks out a subtype, etc.

Back to the physical exam. After running through my family’s medical history and mine, my drug allergies, my current medications, and so on, I got a booster tetanus shot (plus booster whooping cough vaccine) and was wheeled off to physical therapy, where I bought a leg-lifter and a reacher (also known as a grabber). These are devices to help people with motion disabilities, arthritics for instance.

A digression on assistive terminology. A leg-lifter is a rod with a loop on one end to put your hand through, to steady the rod as you wield it, and a bendable metal loop on the other to slip over a foot so you can lift your leg with the device (without bending over and picking up your leg with the opposite hand). A very simple device:

Leg-lifter is a synthetic compound in -er, incorporating the direct object leg of the verb lift (there’s also a synthetic compound in -ing).

Then there’s the reacher (which seems to be the marketing name) or grabber (the name my orthopedist uses), a device with a trigger grip on one end, which closes a jaw at the other, to pick up reasonably light objects below or above you (on the floor or a low shelf, or on a high shelf), allowing you to avoid bending or stretching, both things that are bad for a new hip joint (and painful for an old arthritic one). The device:

The larger semantic domain to which leg-lifters and reachers — and long-handled shoe horns, and other devices helping with ADLs (an initialism for activities of daily living, another technical term) — belong is a subdomain of a larger semantic category that goes by the technical name assistive technology. From Wikipedia:

Assistive Technology is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them. AT promotes greater independence by enabling people to perform tasks that they were formerly unable to accomplish, or had great difficulty accomplishing, by providing enhancements to, or changing methods of interacting with, the technology needed to accomplish such tasks.

Not a miracle of expository prose, and it goes on to split hairs on the distinction between assistive and adaptive technology, treating the former as the general term for devices that increase or maintain functional capabilities of people with disabilities, and the latter as a more restrictive term for devices specifically designed to do this. Putting that aside, there are still a number of subtypes of assistive devices, among them:

Virtually none of these categories has an ordinary-language name, which is why we’ve fallen into this cluster of technical and semi-technical terms.

Saturday. After breakfast, off to the labyrinth-under-construction of the Stanford Univ. Medical Center (where the surgery will be performed), to get a blood draw done for blood typing (SUMC insists this must be done in their labs; PAMF won’t do).

Digression on blood draw, with the nouned V draw in it. A N+N compound with blood functioning as the object of the V draw. This particular compound isn’t in the OED, but OED2 does note the nouning draw,

An act of drawing, in various senses of the vb. [examples from 1663 on]

Various senses indeed: note quick draw and beat someone to the draw, a big draw for certain audiences, a draw of cards or lots in a raffle, a match or game ending in a draw,…

The blood of blood draw is a count noun, with semantics distinct from the drawing of the synthetic compound blood drawing, which is a mass noun.

Continuing with Saturday. Needing shoes that could be easily slipped on and off — nothing requiring bending down and tying or fastening! — and would accommodate feet with very prominent bunions, I went (by Traugottmobile) to the Palo Alto store of Footwear Etc. this morning. Very soon thereafter I left wearing handsome, and very comfortable, black glove leather loafers by Mephisto. Rather expensive, even with the 10% discount, but I’m deeply pleased. (Pre-bunions, I pretty much lived in Florsheim loafers.) The item:

MEPHISTO [headquartered in Oak Park IL] is quite simply the finest walking shoe on earth. Its comfort, support and durability are recognized wherever people take walking seriously. In fact, Mephisto has become the most popular walking shoe in virtually every country in which it’s been introduced, selling more than 1.5 million pairs annually in Europe alone. Throughout over three decades of existence, Mephisto has been in the forefront of innovation in walking shoe design and construction. We have been responsible for such revolutionary features as speed lacing and air-circulating insoles. What’s more, while other walking shoes are often 100% synthetic, rarely seeing a human hand in their manufacture, Mephisto remains a natural product (soft leather, latex, cork and rubber) and continues to be hand made one shoe at a time in the matchless European tradition.

The two quotes from the Mephisto site barely scratch the surface of the technical terminology of shoe-making: uppers and insoles, plus (new to me) speed lacing, in which the laces are entirely on the surface of the shoe (illustrated here).

3 Responses to “Pre-op days”

The predominant normal hemoglobin is hemoglobin A1. A certain amount of blood sugar gets stuck to it as it ages, and that’s hemoglobin A1c. Normal blood has a few percent of hemoglobin A2, though why nobody is sure. Fetuses produce hemoglobin F, which is almost entirely replaced by hemoglobin A in the first months of life.

Carriers of the sickle cell anemia gene produce an abnormal hemoglobin, hemoglobin S, whose molecules if oxygen levels fall stick to themselves abnormally and form long crystal-like structures in sickle cells. About 10% of African-Americans have at least one hemoglobin S gene. About 3% of African-Americans have hemoglobin C.

There are several hundred known abnormal hemoglobins, many of them confined to a single kindred. Some of these function completely normally, while others bind oxygen abnormally or do other weird things to cause trouble.